임플란트 고정성 보철물에서 수와 식립위치 변화에 따른 골과 임플란트에서의 응력분포에 관한 3차원 유한요소법적 연구

Effect of the Number and Location of Implants on the Stress Distribution in Three-unit Fixed Partial Denture: A Three-Dimensional Finite Element Analysis

  • 이우현 (단국대학교 치과대학 보철학교실) ;
  • 임종화 (단국대학교 치과대학 보철학교실) ;
  • 조인호 (단국대학교 치과대학 보철학교실)
  • Lee, Woo-Hyun (Department of Prosthodontics, College of Dentistry, Dankook University) ;
  • Lim, Jong-Hwa (Department of Prosthodontics, College of Dentistry, Dankook University) ;
  • Cho, In-Ho (Department of Prosthodontics, College of Dentistry, Dankook University)
  • 투고 : 2010.04.11
  • 심사 : 2011.09.25
  • 발행 : 2010.09.30

초록

본 연구에서는 임플란트 지지 3-unit 고정성 보철물에서 임플란트의 수와 위치변화에 따른 지지골과 임플란트에서의 응력 분포를 삼차원 유한요소분석법으로 관찰하고자 하였다. 3개의 임플란트를 중심선 일직선상에 나란히 식립한 모델과 중심선에서 제1대구치 임플란트를 협측으로 1.5mm offset 시키고 나머지 임플란트는 설측으로 1.5mm offset 시킨 모델 및 이와 반대로 offset 시킨 모델 그리고 2개의 임플란트를 이용하여 양단 지지한 모델과 근심 및 원심 캔틸레버 모델을 만들고, 교합력도 제2소구치에만 155N을 작용한 경우, 제2대구치에만 206N을 작용한 경우, 제1소구치에는 155N, 제1, 2대구치에는 각각 206N을 동시에 적용한 경우에 대해 각각 협측 교두에 설측방향으로 $30^{\circ}$ 경사하중을 적용시켰을 때와 치아 중심와에 수직하중을 적용했을 때에 대해 유한요소법을 이용하여 골과 임플란트에 발생하는 응력 분포를 관찰하였다. 이 같은 실험 결과를 바탕으로 각각의 응력을 비교하여 다음과 같은 결과를 얻었다. 어떤 하중이 작용하더라도 더 많은 수의 임플란트를 이용하여 제작한 수복물이 골과 임플란트 자체에 작은 응력이 발생하였으며, 3개 구치 상실의 경우에 2개의 임플란트로 지지할때는 양단지지 수복물이 유리한 결과를 나타내었고, 중심와 수직하중이 아니고 협측경사 하중일 때는 협측으로 offset 한 것이 가장 좋은 결과를 나타내었다.

Bone loss may occur depending on the loading conditions. careful treatment planning and prosthetic procedures are very important factors for the proper distribution of stress. Evaluate the stress distributions according to numbers and location of implants in three-unit fixed partial dentures. A mandible missing the right second premolar, first molar and second molar was modeled. Using the CT data. we modeled a mandible with a width of 15mm, a height of 20mm and a length of 30mm, 2mm-thickness cortical bone covering cancellous bone mallow. An internal type implant and A solid type abutment was used. A model with 3 implants placed in a straight line, offset 1.5 mm buccally, offset 1.5 mm lingually and another model with 3 implants offset in the opposite way were prepared. And models with 2 implants were both end support models, a mesial cantilever model and a distal cantilever model. Three types of loading was applied; a case where 155 N was applied solely on the second premolar, a case where 206 N was applied solely on the second molar and a case where 155 N was applied on the first premolar and 206 N was applied on the first and second molar. For all the cases, inclined loads of 30 degrees were applied on the buccal cusps and vertical loads were applied on the central fossas of the teeth. Finite element analysis was carried out for each case to find out the stress distribution on bones and implants. This study has shown that prostheses with more implants caused lower stress on bones and implants, no matter what kind of load was applied. Furthermore, it was found out that inclined loads applied on implants had worse effects than vertical loads. Therefore, it is believed that these results should be considered when placing implants in the future.

키워드

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